Time Course of Atrial Fibrillation in Patients With Congenital Heart Defects

Abstract

Age at development of AF in patients with CHD is relatively young compared with the patients without CHD. Coexistence of episodes of AF and regular AT occurred in a considerable number of patients; most of them initially presented with regular AT. The fast and frequent progression from paroxysmal to (long-standing) persistent or permanent AF episodes justifies close follow-up and early, aggressive therapy of both AT and AF.

Thromboembolic episodes related to atrial arrhythmias in adults with transposition of great arteries

“…In addition to occurring at higher rates, AF also seems to have presented at a much younger age in our cohort. This is consistent with other studies showing relatively young age at development of AF in patients with ACHD [10]. Risk stratification systems such as CHADS 2 [11] and CHADS-VASc [12] have been validated for use in non-valvular AF in the general population, but may not apply to ACHD.…”

Progression of late postoperative atrial fibrillation in patients with tetralogy of Fallot

“…In more than 60% of the study population, AF coexisted with regular SVT, which is much higher compared to the 33% that was reported in an earlier study with 199 patients with various CHD and AF . This observation suggests that ToF patients are more prone to development of regular SVT compared to patients with other CHD.…”

“…Previous studies identified palliative shunting prior to total ToF correction as a predictor for SVT and AF . Also, it was suggested that regular SVT might facilitate development of AF in CHD patients …”

Atrial tachyarrhythmias after atrial switch operation for transposition of the great arteries: Treating old surgery with new catheters

“…In this study, TGA patients were relatively young at onset of AF compared to patients with several other, less complex CHD 58. It is likely that AF in this patient population is not only the result of aging.…”

“…It is likely that AF in this patient population is not only the result of aging. Other proarrhythmic factors include the presence of scars, suture lines and11 intra-atrial conduction abnormalities and local dispersion in refractoriness due to chronic hemodynamic stress 22,58. Frankel et al reported outcomes of pulmonary vein isolation in a TGA patient after the Mustard operation who presented with recurrent episodes of AF 22.…”